Provider Demographics
NPI:1265086664
Name:LU HOMECARE REHABILITATION SERVICE LLC
Entity type:Organization
Organization Name:LU HOMECARE REHABILITATION SERVICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KHANH
Authorized Official - Middle Name:CONG
Authorized Official - Last Name:LU
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:732-404-7160
Mailing Address - Street 1:206 MOUNTAIN VIEW TER
Mailing Address - Street 2:
Mailing Address - City:BRANCHBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08853-4193
Mailing Address - Country:US
Mailing Address - Phone:732-404-7160
Mailing Address - Fax:
Practice Address - Street 1:236 FERRY ST
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07105-5401
Practice Address - Country:US
Practice Address - Phone:973-589-7772
Practice Address - Fax:973-589-8228
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-24
Last Update Date:2019-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy